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$7M Health Care Heist Uncovered in Miami
A shocking healthcare scandal has rocked Miami, as a former director of nursing pleaded guilty to his role in a massive $7 million Medicare fraud scheme. Armando Buchillon, 42, of Hialeah, Florida, faces sentencing on October 6, 2014, for one count of conspiracy to commit healthcare fraud.
According to court documents, Buchillon was a key player in the scheme, working as a director of nursing at Anna Nursing Services Corp. (Anna Nursing), a defunct home health care company in Miami. The owners and operators of Anna Nursing allegedly operated the agency to bill the Medicare Program for expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
As part of the scheme, Buchillon and his co-conspirators regularly falsified patient documentation to make it appear that beneficiaries qualified for and received home health care services, when in fact, many of the beneficiaries did not qualify for or receive such services. Additionally, Buchillon paid kickbacks and bribes to patient recruiters in exchange for patients to Anna Nursing for home health care and therapy services that were medically unnecessary and/or were not provided.
Buchillon worked as a patient recruiter for Anna Nursing and was paid kickbacks and bribes by the owner of Anna Nursing. The scheme caused the submission of false and fraudulent claims to Medicare on behalf of these beneficiaries.
From approximately October 2010 through approximately April 2013, Anna Nursing was paid by Medicare approximately $7 million for fraudulent claims for home health care services that were medically unnecessary and/or were not provided.
The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case is being prosecuted by Trial Attorneys A. Brendan Stewart and Anne P. McNamara of the Criminal Division’s Fraud Section.
The Medicare Fraud Strike Force, operating in nine cities across the country, has charged nearly 1,900 defendants who have collectively billed the Medicare program for more than $6 billion. The HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
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Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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